*Review* **Performing Microdissection Testicular Sperm Extraction: Surgical Pearls from a High-Volume Infertility Center**

**Giovanni M. Colpi 1,\* and Ettore Caroppo 2**


**\*** Correspondence: gmcolpi@yahoo.com

**Abstract:** Microdissection testicular sperm extraction (mTESE) has been demonstrated to be the gold-standard surgical technique for retrieving testicular sperm in patients with non-obstructive azoospermia (NOA) as it enables the exploration of the whole testicular parenchyma at a high magnification, allowing the identification of the rare dilated seminipherous tubules that may contain sperm, usually surrounded by thinner or atrophic tubules. MTESE requires a skilled and experienced surgeon whose learning curve may greatly affect the sperm retrieval rate, as demonstrated in previous reports. The present review is intended to offer a precise and detailed description of the mTESE surgical procedure, accompanied by an extensive iconography, to provide urologists with valuable information to be translated into clinical practice. Advice about the pre-surgical and post-surgical managemen<sup>t</sup> of patients is also offered.

**Keywords:** microTESE; sperm retrieval; non-obstructive azoospermia; male infertility

**Citation:** Colpi, G.M.; Caroppo, E. Performing Microdissection Testicular Sperm Extraction: Surgical Pearls from a High-Volume Infertility Center. *J. Clin. Med.* **2021**, *10*, 4296. https://doi.org/10.3390/jcm10194296

Academic Editor: Alberto Ferlin

Received: 21 July 2021 Accepted: 20 September 2021 Published: 22 September 2021

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